Donald Berwick, the Pro-Gun Control Lobby, and Paternalism
Q: What do Donald Berwick and gun control advocates have in common?
A: Both distrust ordinary Americans' ability to exercise individual rationality and responsibility. Instead, they believe that the government should restrict our freedoms for our own good. And if they have their way, we'll end up paying the price.
Dr. Donald Berwick is President Obama's newly appointed head of Medicare and an unabashed supporter of socialized medicine. He has repeatedly praised the British National Health Service as a model for the United States to emulate.
The Wall Street Journal recently published a selection of Berwick's public statements on health policy. Two in particular stand out because they are such naked attacks on the efficacy of individual choice and rationality:
1) I cannot believe that the individual health care consumer can enforce through choice the proper configurations of a system as massive and complex as health care. That is for leaders to do.
2) The unaided human mind, and the acts of the individual, cannot assure excellence. Health care is a system, and its performance is a systemic property.
Hence, Berwick has explicitly called for doctors to relinquish their "clinician autonomy" and instead follow standardized government treatment guidelines. Patients should forgo using their "unaided human minds" and instead let their "leaders" decide what kind of medical care they should receive.
Many gun control advocates display a similar disdain for the rationality of ordinary Americans. This can be seen most clearly whenever a state considers allowing law-abiding citizens to carry concealed firearms.
In 1987, the state of Florida started granting concealed weapons permits to residents on a "shall issue" basis, meaning that anyone who met standard training requirements and who passed a criminal background check would be granted a permit. Prior to that, most states gave broad discretion to local sheriffs and police chiefs to grant (or deny) such permits for any reason they wished. In practice, this often meant that only those who were politically connected (or who had made significant contributions to the sheriff's re-election campaign) were granted a permit.
As Florida considered this reform, gun control advocates argued that allowing ordinary civilians to carry firearms would turn peaceful towns into "Dodge Cities." Blood would run in the streets, they claimed. Yet nothing of the sort has happened, either in Florida or in the numerous other states that have since adopted similar laws.
As Howard Nemerov and others have shown, states that allow citizens to carry firearms are safer than states that don't. An armed citizenry deters crime.
Equally important, armed citizens do not get into shootouts over trivial disagreements, such as who arrived first at the best parking spot at the local grocery store. Instead, the millions of ordinary armed Americans across the country have exercised the proper rationality, restraint, and responsibility that comes with carrying an instrument of deadly force.
But despite over 20 years of statistics showing that Americans can and do responsibly exercise their Second Amendment rights, this has not stopped gun control advocates from raising the same fallacious "Dodge City" argument every time a new state considers allowing honest citizens to carry concealed weapons.
A similar phenomenon occurred in the recent national health care debate. Despite decades of statistics showing that patients in Canada and Great Britain suffer greater mortality from cancer and other serious diseases than U.S. patients, this has not stopped men like Berwick from advocating the adoption of the same failing socialized health system here in the United States.
So why do the health care and the gun control statists persist in their wrong views despite the evidence to the contrary? As writer Ayn Rand once noted, "the trouble is not in the nonsense they accept, but in what makes them accept it." In this case, the statists are driven by a fundamentally flawed view of human nature.
Like Berwick, many gun control advocates disdain the rationality of ordinary men. As Jeffrey Snyder observed in "Fighting Back: Crime, Self-Defense, and the Right to Carry a Handgun":
...[P]roponents of the "Dodge City" argument can only believe that common, ordinary law-abiding citizens are seething cauldrons of homicidal rage, ready to kill to avenge any slight to their dignity, eager to seek out and summarily execute the lawless. Only lack of immediate access to a gun restrains them and prevents the blood from flowing in the streets. They are so morally and mentally deficient that they will readily mistake their permit to carry a weapon in self-defense as a state-sanctioned license to kill at will. ... People are basically accidents or crimes waiting to happen.
Supporters of shall-issue licensing laws ... [hold] a decidedly different view of their fellow citizens — namely, that they are not creatures driven by impulse and desire but are entitled to the trust properly accorded a moral and rational being capable of exercising judgment and self-control. Supporters of shall-issue licensing laws implicitly believe that a person's character and actions do not fundamentally change merely because he has a tool at hand with which he can more perfectly and readily act on his fleeting impulses and desires. ... [P]ermitting them to carry a firearm (which they already have the de facto ability to do) will not change their character or fundamental nature or their actions.
In other words, both the gun control statists and the health care statists believe that we are fundamentally irrational creatures incapable of managing our lives. Hence, the government must restrict our freedoms for our own good.
The statists' paternalistic view of human nature also explains their constant double-standards. Men like Berwick believe they are qualified to impose draconian rules over the citizenry, because we cannot make such decisions for ourselves. But as the wiser "leaders," they need not follow the same rules themselves.
Hence, Berwick has exempted himself from his own Medicare restrictions. Similarly, many of the strongest opponents of gun rights have no qualms about using their political “pull” to enable themselves and their cronies to carry guns for self-protection.
(A similar double-standard exists with the global warming issue, where climate alarmists berate ordinary Americans for their "carbon footprints," while jet-setting to international conferences to criticize the very industrial society that makes such air travel possible. The climate alarmists' proposed carbon restrictions are apparently for the little people only.)
Stripping individuals of the freedom to act on their best rational judgment has deadly consequences. When the state prevents honest law-abiding Americans from carrying weapons in self-defense, innocent people die. Such a paternalistic policy punishes good people and rewards the evil-doers.
Similarly, when men like Berwick seek to limit the medical care that doctors can provide (and that patients can receive), it will be the innocent ordinary citizens who will suffer from such rationing. The politically connected will always use their "pull" to get the best care, as they already do in Canada. Dr. Lee Kurisko, a physician who has practiced in both Canada and the U.S., calls this the "deep, dark secret" of Canadian health care.
Fortunately, the recent legal and political successes of the gun rights movement have shown how to defeat the statists -- by challenging their premises of human incompetence and irrationality and by instead promoting the principle of individual rights. Gun rights advocates have won by consistently arguing that gun ownership was an individual right -- and that ordinary men could and should be left free to responsibly exercise that right to keep and bear arms.
Opponents of government-run health care should adopt a similar strategy. In addition to challenging ObamaCare on legal and economic grounds, we must challenge it on fundamental philosophical grounds.
We must assert our competence -- and our right -- to make our own medical decisions in consultation with our physicians without government interference. We must demand the right to purchase health insurance (or not) without onerous government mandates specifying which benefits we must purchase and what prices we must pay. And we must demand the right to retain the fruits of our labors so that we can purchase medical services and health insurance according to our own best judgment in a free market, rather than being forced to sacrifice our money, our health, and our lives to a government-run health system that dispenses medical care on its terms, not ours and our physicians.
America was founded on the principle that men had the ability (and the right) to exercise their reason to peacefully pursue their lives and happiness -- and that the proper function of government was to protect that right. In contrast, men like Berwick regard Americans as irrational creatures incapable of living without guidance from supposedly-wiser government masters.
Do we want to live under a government where paternalistic men like Berwick rule over us? Or under a properly limited government whose sole function is to protect our individual rights? The choice is ours.